Parents and guardians are advised that failure to complete the following required health record information within 14 days after school entrance is basis for excluding students from school. Students will not be readmitted to school until the health record requirements are complete.

Immunizations and Physical Exams may be obtained from your private healthcare provider, or at the Lake County Health Department. You may call the Health Department at (440) 350-2554 for further information or to schedule an appointment. Immunizations may be less expensive at the Health Department.

State law requires the Emergency Form be completed annually and on file in the clinic. Parents are responsible for notifying the clinic to changes in information throughout the school year. Please complete both sides of this form.

Must be completed by the student’s physician. A physical is required for admission to preschool and kindergarten, and is recommended for grades 1-12. A physical exam completed within the past twelve (12) months preceding enrollment is acceptable.

Per Ohio Revised Code, Sections 3313.671, 3701.13, and 5104.011 A mandate that a complete record of immunization be filed within 14 days of school admission. The student’s healthcare provider should complete this form.